Headache complaints are frequently encountered in the society. Primary headaches can be defined as pure headaches that are not caused by any other underlying disease, and 90% of headaches in general are primary headaches. The remaining 10% are secondary headaches, which are headaches caused by a different disease.
Migraine headaches can be experienced at any age and at any time. Although the cause of migraine is not known for certain despite the researches, it is known to be familial or caused by environmental factors. There are some factors that play an important role in triggering the pain. These factors can be caused by weather changes, stress or eating, sleeping and activities. If migraine pain is not treated, the person's social life, work performance and daily life can be affected. In addition, no matter how temporary the medications taken continuously are, the fact that the drugs lose their effect over time or the side effects of the drugs used on the person may cause the pain to become chronic. Therefore, it is important to consult a specialist physician in migraine treatment.
What is Migraine?
Migraine, which is frequently seen in the society, is a type of headache that can start at any age and manifests itself with continuous or recurrent pain. Migraine, which is more common in women compared to men, is seen in one out of every 10 men and one out of every 4 women. Migraine is known to be a genetic disorder. Migraine pain, which usually starts in adolescence, is seen in most patients under the age of 30. Pain that occurs in attacks is the most prominent feature of migraine. These pains, which can be severe, sometimes occur several times a year, while sometimes they can occur several times a month.
They are often accompanied by throbbing in one half of the head and these pains decrease as time passes. However, not every headache is a migraine. Migraine is one of the causes of headache. There can be many reasons for the headaches that a person experiences. Migraine is less common in women in the postmenopausal period. After the age of 35, the incidence of migraine decreases.
Although one of the most common symptoms of migraine is a throbbing, severe pain in the nape and temple or around the head starting from the eye area and increasing in intensity with movement, there are also other symptoms. Among the symptoms of migraine; nausea, vomiting, light and sound sensitivity may also occur.
What Causes Migraine?
Although the cause of migraine is being investigated, it is not known for certain. However, it is known that genetic factors and environmental factors play an important role. In addition, triggering factors also prepare the ground for migraine formation. While genetic transmission is mostly seen in migraine with aura, migraine without aura occurs as a result of genetic and environmental factors. In addition, during migraine attacks, some pain-triggering chemicals are detected in the brain and cause migraine pain.
In migraine pain, there is a nervous system that is sensitive to migraine attacks. It can be triggered by environmental/external factors. Triggered by the attack, blood vessels dilate in the area sensitive to migraine pain in the brain, causing inflammation of the nerves. This then causes the trigeminal nerve in the brain to activate, causing migraine.
What are the Symptoms of Migraine?
There are some stages that can occur from the beginning to the end of migraine pain. Migraine attacks start with the prodrome phase. After the prodrome phase comes the aura period. This period lasts for about an hour. Although the pain is always felt on the same side during migraine attacks, it usually starts in the nape of the neck and can spread all around the head. Migraine symptoms that may occur from time to time may cause more discomfort than pain. The period after the pain is the postdrome period. In this period, the pain decreases and a feeling of relief occurs.
Migraine Stages
Migraine attacks can occur in four different stages:
Prodrome
One or two days before the onset of this type of headache, there may be some symptoms of impending migraine pain. These symptoms can be listed as follows:
- Constipation
- Desire to eat
- Changes in mood (pessimism, restlessness)
- Neck stiffness
- Thirst and frequent urination
Aura
Migraine pain is divided into two categories: with and without aura. In migraine patients with aura, neurological disorders can be seen before and after the pain. Symptoms in migraine patients with aura can be seen as follows:
- Speech disorder
- Visual impairment
- Numbness and tingling
- Weakness in tactile sensation
- Headache
Atak
Untreated migraine attacks can last between 3-72 hours. These attacks can occur several times a week or rarely several times a month. The following symptoms may occur during an attack:
- Nausea and vomiting
- Throbbing
- Throbbing like heart palpitations
- Light, sound and touch sensitivity
- Blurred vision
- Fainting, although rare
Postdrome (after a migraine attack)
In the post-attack period, the patient may feel exhausted, tired and somewhat relieved. The following symptoms can be seen in the first 24 hours of the postdrome
- Dizziness
- Restlessness
- Light and sound sensitivity
- Powerlessness
Warning: If you experience any of the following symptoms, it is important to see a doctor immediately:
- Sudden and severe headache
- High fever
- Stiffness in the neck
- Confusion and trouble perceiving, lethargy
- Double vision
- Speech impairment
- Worsening of a headache following a head injury
- Headaches caused by coughing, exertion, straining and sudden movements
How is Migraine Diagnosed?
To answer the question of how migraine is diagnosed, first of all, the patient's medical history and complaints are listened to by the specialist physician. The physician performs a physical examination of the patient, provided that it is the head and neck region. Then, he/she diagnoses migraine by making a personalized treatment plan. During the examination process, complaints such as examination of muscle structures, muscle contraction in the neck and back region, eye and facial pain starting from the neck are examined in detail.
Physiological disorders may affect the perception of pain more. Therefore, factors such as the patient's diet, sleep patterns and stress levels should be taken into account in the diagnostic process as they may have an impact on pain. According to researches, more than half of the patients experience pain due to psychological reasons. Therefore, neurosurgery, neurology, psychiatry and physical therapy departments should be integrated in the diagnosis of migraine.
How is Migraine Treated?
Medication is frequently used in migraine treatment. It includes painkillers used to prevent migraine attacks, the frequency of pain attacks, or the symptoms accompanying these pains (vomiting, nausea, etc.). In migraine treatment, the treatment strategy depends on the frequency and severity of the headaches and other accompanying symptoms.
Drugs used in migraine treatment are divided into two categories:
Painkillers
It is taken during migraine attacks and is used to stop the pain.
Medicines used in preventive treatment:
These medications are taken daily and at regular intervals to control the severity or frequency of migraine attacks.
In migraine treatment, laboratory tests and radiological examinations are used to rule out other possible causes of headache other than migraine.
Warning: The use of some medications in migraine patients who are pregnant or breastfeeding is harmful for the baby. Some medicines should not be given to pediatric migraine patients. In such cases, you should consult a specialist doctor before using medication.